Topic overview

Start with the big picture

Glucocorticoid adverse effects span changes in weight and glucose regulation, adrenal suppression, bone loss, cardiovascular and gastrointestinal complications, mood or sleep changes, eye effects, skin changes, infection risk, and electrolyte disturbances. Some concerns require particular attention: stopping treatment abruptly after more than two to three weeks may risk acute adrenal crisis, while high-dose systemic use calls for avoiding live attenuated vaccines. Diabetes, hypertension, heart failure, osteoporosis, psychiatric illness, and glaucoma are among the comorbidities that warrant caution. Pregnancy, interacting medicines, and ongoing monitoring also shape safe use. Inhaled and topical corticosteroids can still have systemic effects; rinsing the mouth after inhalation helps prevent oropharyngeal candidiasis.